Novel target volume marked adult bag to deliver accurate tidal volume for paediatric and adolescent resuscitation

Abstract

Aim: To overcome limitations of inaccurate tidal volume (TV) delivery by conventional selfinflating paediatric and adult bags during paediatric and adolescent resuscitation, we designed a novel target volume marked bag (TVMB) with four compression points marked on an adult bag surface. The aim of this study was to evaluate the TVMB in delivering preset TV.

Methods: Fifty-three subjects (28 doctors, 17 nurses, 8 paramedics) participated in this simulation trial. TVMB, paediatric bag and adult bag were connected to a gas flow analyser for measuring TV and peak inspiratory pressure (PIP). In a random cross-over setting, participants delivered 10 ventilations using the adult bag, paediatric bag or TVMB in each of four target volume ranges (100-200 ml, 200-300 ml, 300-400 ml, 400-500 ml). We compared TV and PIP for the adult bag, paediatric bag and TVMB in each subject.

Results: Compared with the paediatric bag, TVMB showed higher rates of accurate TV delivery in the 200-300 ml target volume range (87-90% versus 32-35%; p < 0.05). Compared with the adult bag, TVMB showed higher rates of accurate TV delivery in all target volume ranges (75-90% versus 45-50%; p < 0.05). The frequency of too high or low TV delivery was higher with the adult bag than TVMB (20-30% versus 0-5%; p < 0.05). There was no significant difference in PIP between the paediatric bag and TVMB (within 5 cm H(2)O; p < 0.05).

Conclusions: TVMB could deliver accurate TV in various target volume ranges for paediatric and adolescent resuscitation.